Laboratory approach to investigation of anemia with a focus on pyruvate kinase deficiency

Abstract

Anemia is a major health burden worldwide and affects approximately one-third of world's population. It is not a diagnosis; it is a manifestation of an underlying pathophysiology leading to either decreased hemoglobin (Hb), hematocrit (Hct), or red blood cells (RBCs). Iron deficiency anemia is still the most common cause of anemia worldwide. The symptoms are usually due to the underlying compensatory responses to decrease in oxygen delivery to the tissues. Laboratory investigation should start with complete blood count (CBC), reticulocyte count (RC), and peripheral smear evaluation. Further testing depends on these indices, that is, iron parameters and hemoglobinopathies/thalassemia evaluation in microcytic hypochromic anemia, vitamin B12, and folic acid level in macrocytic anemia. Increased RC denotes adequate bone marrow response and points toward hemolytic process and vice versa. Anemia diagnosis can be complex and confusing for the practicing physician. This review tries to give a practical simplistic approach to the diagnosis, focusing mainly on the basic parameters, that is, CBC, RC, and peripheral smear etc. Moreover, we have also tried to provide an update on the pyruvate kinase deficiency, as there has been recent exciting development in the management of these patients. K E Y W O R D Sanemia, pyruvate kinase deficiency, reticulocytes

Diagnostic Significance of Measuring Reticulocyte Maturity Indices in Iron Deficiency Anaemia

“…Maturation time of reticulocytes might decrease in bone marrow in case of severe anaemia, 16 as higher quantity of immature reticulocytes are discharged in the peripheral blood and stay there for an estimated more than 48 hours until these get transformed into mature RBCs, hence, number of immature reticulocy-Pak Armed Forces Med J 2021; 71 (6): 2112 tes in the peripheral blood is increased. 17 Indices linked to immaturity of reticulocytes are increased in IDA demonstrating a decline in raw materials required for the production of hemoglobin and transformation of reticulocytes into mature RBCs.…”

Clinical Study On the Impact of Amino Acids, Multi-Minerals, and Vitamins Combination Against Small Ruminants With Anemia In New Valley Governorate

“…Anemia is categorized differently depending on the pathophysiological feature or the complete blood count (CBC) parameters [6]. The first main classification, according to the pathophysiology, is subdivided into hemolytic type, where there is an elevation in RBCs break down, and hypo proliferative type, where RBCs creation is reduced [7].…”

A MATLAB model for diagnosing sickle cells and other blood abnormalities using image processing

“…Three major abnormalities can be recognized when blood particles counting is achieved. These types of abnormality are summarized below: a) Fewer number of RBCs than the normal is a clear clue of blood anemia [13], [14]. [15], [16].…”